Book review
Tropical Disease Research; Progress 1975- 94; Highlights 1993-94. Assembled by R. Walgate, with contributions from J. Turner, P. Parker and N. Cater. Geneva: World Health Organization, 1995. Softbound, 167 pp (available in English; French in preparation) ISBN 9241561793. Sw.fr 26/ US$23.40 (in developing countries Sw.fr. 18.20). WHO Order No. 1150427. Order from: WHO, Distribution and Sales, 1211 Geneva 27, Switzerland.
"This book provides a lively account of the ambitions and obstacles, successes and setbacks that have characterized the fight against tropical diseases over the past two decades. The report, which also describes the current state-of-the-art in tropical disease research, commemorates the 20th anniversary of the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR). Established in 1975, TDR is devoted to the development of applicable, appropriate, and affordable methods to control the major tropical diseases.
"The opening chapter, which contains contributions from the first and second directors of TDR, provides a first-hand account of the program's origins and initial goals. Apart from providing a record of the program's earliest years, these personal stories reveal some of the hotly debated controversies, backroom discussions, and critical decisions that shaped TDR and contribute to its character as a unique institution. Above all, the chapter underscores the strength and validity of an early conviction that quality science could be a powerful weapon in the struggle to combat these under-researched diseases.
"The second chapter, contributed by the program's present director, describes the challenges currently faced by TDR, explains how the program has evolved to meet these challenges, looks at specific achievements, and asks whether these successes can be sustained in a world undergoing political as well as biological evolution. Future-orientd as well as retrospective, the chapter also considers prospects for the elimination or eradication of diseases such as leprosy and river blindness. Chapter three, on research capability strengthening, uses three stories from three continents to show how the program works to encourage high quality research in tropical countries and thus foster self reliance.
"The main part of the report consists of chapters focused on each of the major tropical diseases: malaria, schistosomiasis, lymphatic filariasis and onchocerciasis, leprosy, African trypanosomiasis, Chagas disease, and leishmaniasis. Together, these chapters provide a journalistic, objective, and sometimes critical review of what 20 years of investment in TDR means in terms of tangible outcome. Each chapter is organized according to a common framework which covers problems in 1975, solutions in 1995, remaining problems, and TDR's specific contributions during the past 20 years. Achievements range from progress in the development of malaria vaccines to use of a simple school questionnaire to identify communities at risk of schistosomiasis, from the development of a new test to detect leprosy in low-endemic areas to the discovery that soap, water, and antibiotics can dramatically improve elephantiasis.
"Concerning the fundamental problem of finding the resources to combat the diseases of poor people in poor countries, the report also cites numerous TDR achievements, including special agreements with industry and support for the low-cost manufacturing of drugs in developing countries. The remaining chapters provide an overview of progress in the biological control of vectors and in social and economic research.
"Throughout the report, the personal experiences related by hundreds of scientists and other TDR collaborators enliven this account of steady, impressive progress in combating some of humanity's most terrible-and neglected -diseases." -WHO New Book Announcement